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General NPI Number Information
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NPI Number | 1447379409
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Entity Type | Individual
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Provider Name | ALI OKHOVAT O.T.R
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Gender | Male
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 184 BETHLEHEM PIKE
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City | PHILADELPHIA
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State | PA
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Zip | 19118-2815
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Country | US
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Telephone | 215-247-5311
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Fax |
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Provider Business Mailing Address
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Address Line | 502 HEATHER DR
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City | TELFORD
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State | PA
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Zip | 18969-1217
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Country | US
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Telephone | 215-720-5151
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OC00517L
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License Number State | PA
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